Intacs vs. Laser Vision Correction

Serving New York City, Long Island, and Manhattan, NY

Intacs and laser vision correction are very different approaches to vision improvement and to some extent address different eye conditions. However, they can both treat myopia (nearsightedness) and astigmatism.

What are Intacs?

Intacs are curved plastic slivers that are placed in the cornea to flatten its curvature. A myopic eye has a steeply curved cornea that bends (refracts) light too sharply. When the curve is slightly flattened, light is refracted less sharply and can focus clearly on the retina. Intacs flatten the corneal center by pushing sideways against its periphery. They cannot correct farsightedness (hyperopia).

However, they can correct astigmatism at the same time as they correct myopia. Astigmatism is blurry vision at all distances caused by an oval-shaped cornea like a football. A football has two curvatures: the flatter one in the longer dimension and the steeper one in the shorter dimension. These two corneal curvatures refract light in two different ways. Intacs can be positioned in the corneas so as to give it a more spherical shape and that corrects astigmatism.

While Intacs can be a good treatment for astigmatism and mild myopia, they are most often used for Keratokonus, where the cornea is gradually becoming thinner and bulging forward. Intacs help to counteract the bulging curvature by slightly flattening it.

Please see our page on Intacs for more details.

What is Laser Vision Correction?

LASIK and the LASIK alternatives such as PRK and Epi-LASIK all use a type of laser called an excimer laser to change corneal curvature. The laser is extraordinarily precise and is programmed to follow a custom treatment plan that Dr. Kelly will determine for you ahead of time.

• For myopia, the laser flattens the cornea by vaporizing tiny pieces of tissue from the corneal center
• For hyperopia (farsightedness), the laser steepens the cornea by vaporizing pieces from the periphery
• For astigmatism, the laser vaporizes tissue so as to give the cornea a more spherical shape rather than oval.

A vision correction laser flattens the corneal curvature in a different way than is done by Intacs but has the same improving effect on your vision.

LASIK and its alternative procedures do not treat Keratoconus. On the contrary, they have sometimes caused a similar condition called ectasia, where the cornea bulges forward. That is because the laser has removed too much tissue from the cornea and left it too thin to maintain its curvature against the eye's internal pressure. The fluids in the eye push outwards and the cornea must be thick enough to counteract that. Ectasia differs from Keratoconus in that the thinning is not progressive.

Differences Between Intacs and Laser Vision Correction

1. Intacs are a reversible procedure. They can be removed and replaced with more effective Intacs as keratoconus progresses; or they can be left out of the eyes. In that case the eyes revert to their previous visual distortion.
• The laser removes corneal tissue permanently and is not reversible.
• Intacs can treat any degree of myopia, even very severe myopia.
• The laser procedures can correct only mild or moderate myopia.
• Intacs cannot treat hyperopia.
• The laser procedures can and do.
• Intacs can treat keratoconus.
• Laser vision correction cannot treat Keratoconus.
• Intacs are a less invasive procedure, as they are simply positioned in a laser made tunnel outside the axis of vision and can be removed any time.
• Laser procedures work on a corneal layer below the surface which requires creating a temporary flap, folding it back for treatment, and then replacing it. Flap creation methods are the big difference between LASIK and the various alternatives. PRK creates no flap but simply removes surface tissue completely, allowing it to grow back after the procedure.

If you would like to have your vision improved, the first step would be to schedule a personal consultation with Dr. Kelly. He would listen to your concerns, answer your questions, and explain how different procedures could help you. Then you would need to make an appointment for a full eye examination. Dr. Kelly would then be able to determine your best treatment plan.

If you would like to go ahead and set up your consultation, please contact our eye care office today. We serve New York's Manhattan and Long Island areas and we hope to work with you soon.